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Lessons learned from the PRESERVE trial.

Sasan Partovi1,2, Thomas Trischman3, Preet S Kang2

  • 11 Section of Vascular and Interventional Radiology, Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University , Cleveland, OH , USA.

The British Journal of Radiology
|May 18, 2018
PubMed
Summary
This summary is machine-generated.

The PRESERVE trial found that acetylcysteine and sodium bicarbonate do not prevent kidney injury from contrast dye better than IV fluids. Hydration alone is as effective as other strategies for contrast-induced renal sequelae prevention.

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Area of Science:

  • Nephrology
  • Cardiology
  • Radiology

Background:

  • Contrast-induced acute kidney injury (CI-AKI) is a significant concern in high-risk patients undergoing procedures with iodinated contrast media.
  • Existing preventive strategies, including oral acetylcysteine and intravenous sodium bicarbonate, have shown variable efficacy.

Purpose of the Study:

  • To evaluate the effectiveness of commonly used strategies for preventing CI-AKI compared to intravenous hydration.
  • To provide insights into the strengths and weaknesses of the PRESERVE trial in the context of prior research.

Main Methods:

  • The PRESERVE trial, the largest of its kind, compared oral acetylcysteine and i.v. sodium bicarbonate against i.v. hydration with isotonic saline.
  • The study focused on high-risk patients undergoing procedures requiring iodinated contrast agents.

Main Results:

  • The PRESERVE trial concluded that neither oral acetylcysteine nor i.v. sodium bicarbonate demonstrated superiority over simple i.v. hydration.
  • These interventions did not offer additional benefit in preventing contrast-induced renal sequelae.

Conclusions:

  • Intravenous hydration with isotonic saline is as effective as other tested strategies for preventing CI-AKI in high-risk individuals.
  • Future research should focus on developing individualized preventive approaches tailored to specific patient populations to mitigate CI-AKI risk.